| Eloise J Pankratz, Lscsw, Llc | |
|
1143 S Governeour Rd Wichita KS 67207-2812 | |
| (316) 772-2000 | |
| Not Available |
| Full Name | Eloise J Pankratz, Lscsw, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1143 S Governeour Rd, Wichita, Kansas |
| Authorized Official Name and Position | Eloise J Pankratz (LSCSW) |
| Authorized Official Contact | 3167722000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eloise J Pankratz, Lscsw, Llc 1143 S Governeour Rd Wichita KS 67207-2812 Ph: (316) 772-2000 | Eloise J Pankratz, Lscsw, Llc 1143 S Governeour Rd Wichita KS 67207-2812 Ph: (316) 772-2000 |
| NPI Number | 1861922809 |
|---|---|
| Provider Enumeration Date | 06/13/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 7517233505 |
|---|---|
| Medicare Enrollment ID | O20171018002501 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861922809 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 4665 (Kansas) | Primary |
| Provider Name | Eloise Jost Pankratz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336379130 PECOS PAC ID: 8426324419 Enrollment ID: I20171018003000 |
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